A drainable ostomy system is a type of pouch that can be reused. Unlike the closed ostomy pouch, this type has a feature for draining the accumulated discharge in the pouch without needing to discard it.
The mechanism for doing this includes the use of a tap closure, clip closure, velcro or other effective methods that secures the pouch against accidental draining or leakage.
Others do not have an incorporated closing mechanism and depend on a clamp that is applied separately. This system is ideal for patients who have frequent and high volume discharge.
Using a closed system for such patients would be quite the inconvenience because it would mean changing the pouch with much higher frequency. This can lead to skin irritation and predispose the peristomal area to infection.
Drainable ostomy systems are commonly used in patients who have had an ileostomy, upper colon resection or a urostomy. Patients practicing ostomy irrigation can also use the drainable type of pouches.
An ileostomy or upper colon resection creates more discharge because at this point the stool is more fluid than solid. Further water absorption and reabsorption that help in stool solidification mainly take place after the ileum process.
Types of Drainable Ostomy Pouch Systems
- One-piece drainable pouch. In this type the pouch and the skin barrier (also known as wafer or baseplate) of the system are one inseparable piece. The whole system is removed during pouch changing.
- Two-piece drainable ostomy systems. Here the pouch and the wafer (flange, skin barrier) are two different parts. The pouch can be removed independently while the flange can be left in place for up to 4 days before attaching a new one.
What are the advantages of a drainable ostomy system?
- Ideal for patients with high discharge output due to the nature of the operation or due to digestive or ostomy issues.
- Requires changing pouches with less frequency.
- Can be economical in the long-run since fewer pouches are used.
- Easier to drain before disposal.
What are the disadvantages of Drainable Ostomy Systems?
- Difficult to empty solid discharge.
- The draining outlet must be cleaned meticulously. Some patients have difficulties with this or find it repugnant.
- The draining outlet closing mechanism can cause discomfort.
- Increased risk of the draining outlet closing mechanism to give way and spilling the contents of the pouch.
Although drainable ostomy systems do not require frequent changing, it is important to know and identify potential problems that can occur around the stoma. Some of these are:
- Stool leakage behind the flange attachment. This is more likely to be missed in a two-piece drainable pouch. If this happens frequently, it can cause skin sores and discoloration.
- Skin irritation, inflammation and stripping.
- Fungal or bacterial infection of the hair roots of the skin (folliculitis).
- Stomal bruises
Issues like these should be reported to your health care giver for early intervention. This will help to prevent more serious ostomy and general health complications.
The system can also come with an incorporated charcoal filter that helps in the prevention of gas accumulation in the bag. These filters allow the gas to escape but not the odor.